Pulling the Plug

The same week that Los Angeles County officials announced plans to eliminate trauma care at the countys most troubled public hospital, Fox News was prepared to go live from the Kenneth Hahn Hall of Administration to broadcast a debate over a new county seal that substitutes a mission and an indigenous woman for a cross and the Roman goddess Pomona.

The fact that the seal drew more public reaction than the hospital should not surprise. The cross, and its planned removal from the seal, prompted one of the largest public demonstrations the Board of Supervisors had ever seen when the five members first took up the matter earlier this summer. As a symbol of the culture wars, the seal was an easy target for radio talk-show host Dennis Prager, Fox and others who exhorted county residents to prevent their elected officials from doing such a horrid thing.

A petition to keep the seal already is circulating, and there is a good chance that proponents will get the 350,000 signatures needed to put the question on the March ballot. It probably wont make much difference in the end, since the boards action (on a 3-2 vote) came in response to the threat of a lawsuit by the ACLU, and an opinion by county lawyers that the law is on the ACLUs side. Even if the public votes to keep the seal as it is, the courts will likely rule that the cross has to go.

So the furor was no surprise. But it was sad, given the countys inability to provide for the needs of its more than 8 million people and the utter lack of widespread public outcry.

In a span of time that doesnt even cover a year, Californians in general and residents of Los Angeles County in particular have watched and even taken part in a massive defunding of county services. Car-driving voters angered at the tripling of their car taxes helped kick out Governor Gray Davis and install Arnold Schwarzenegger, who rolled back the taxes and squeezed county governments.

The sheriff, Lee Baca, complained that he wasnt getting enough money to do his job and then proved it, releasing hundreds of jail inmates early and, worse, saying it wasnt his fault that suspects and criminals in his charge died from neglect or were murdered in his jails.

In April, Raul Tinajero, a man in something ironically called protective custody, was strangled to death in jail by a suspect whom Tinajero was scheduled to testify against.

Then there was Gustavo Ortega, who was released from jail at 2 a.m. but had nowhere to go. Mentally and physically infirm, he stayed in the jail lobby for three days before anyone noticed him. It was too late.

In the child-care system, abused and neglected children are shuttled off to foster care and turned over to special schools, not because those care homes and those schools are best for the children, but because those homes and schools are eligible for federal financing while the county has to spend dollars it doesnt have if it wants to keep children with family members.

The Board of Supervisors has applied for a waiver to be able to get federal child-care money while still doing what is best for the children. But months have passed and the feds have yet to be heard from. The children still follow the dollars to foster care.

Meanwhile, the county remains in settlement talks over its plan to close Rancho Los Amigos, the nations premier rehabilitation hospital. The county cant afford to keep it open, but the federal court has forbidden it to close.

County health and finance officials say the order means that the health system will run out of money in a year, making it necessary, perhaps, to close other hospitals.

And then there is King-Drew. Where to begin? The infamous Ward 4B, where three people died, apparently needlessly, last summer. Suspect treatment, shoddy patient monitoring. Stun guns to subdue psychiatric patients. Dirty mattresses. A clamp left inside a patient.

Every time one problem was fixed, a federal official said Monday, a new one was discovered.

The bottom line: The county cant do the job itself, and plans to turn the hospital over to a private management team. Drew University is on a short leash, and has less than two years to shape up.

For years, supervisors alternately scolded King-Drew leaders and dragged their own feet to keep from closing the hospital. By Monday, it was clear that either trauma care would be cut, or the whole medical center would be. The irony is that trauma care was one of the areas where King-Drew excelled, in part because the hospital sees so many gunshot victims. Now they will have to be taken further, to Harbor UCLA or to St. Francis, to be treated.

Emergency care remains for heart attack victims and car wrecks. But not trauma care geared to the most critically injured.

It is a remote and unimportant development to anyone outside South Los Angeles  until there is a major accident on the Harbor Freeway, or a terrorist attack at the airport or the harbor. When that happens, we will be mad. At somebody.

Its like Supervisor Yvonne Burke said earlier this year when yet another horror was discovered at King-Drew. Somebody, she said, forgetting perhaps that it was she who for years defended the hospitals shaky record, has really got to get on the ball here.

But who? There is plenty of opportunity to criticize the Board of Supervisors, especially after Tuesdays typically endless meeting that even Fox News abandoned in despair.

But the people of the county put them there, and keep tabs on them, and choose to get excited about the seal and its cross  or in the case of the city of Signal Hill, the oil derricks that are going to be removed, and in the case of Pomona, the goddess Pomona  instead of the welfare of our neighbors.

Voters do pay attention on occasion. Witness for example the vote to impose a tax on themselves to beef up trauma facilities (like the one now slated for closure at King-Drew). And voters may well approve an additional tax later this fall to fund Bacas jails and Sheriffs deputies.

But its not enough. The people, through their county government, provide for the people least able to care for themselves, and are responsible for their decisions.

If, then, a new seal is to be adopted, there are perhaps more appropriate choices for symbols than a mission that looks like a Taco Bell.

For example, an ambulance driving past a shuttered hospital. Or a jail inmate lying prone behind bars. Or an abused child, being forced to chase after a federal dollar bill. Or a county citizen, protecting the old seal.

We may lose the patient, the inmate and the child. But we can still hang on to that seal.